Exam and blood test. A blood test can tell if you have antibodies to HSV 1 and/or HSV 2. If positive, you have HSV in your nerve roots, but both viruses can be either oral or genital. An exam by the doctor when you are having sxs of an ulcer, itching, or burning can verify if the location is genital. A swab can be done for a PCR test of an active lesion, but swabs are not 100% accurate.